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. 2025 Jul 12:61:29-34.
doi: 10.1016/j.athplu.2025.07.002. eCollection 2025 Sep.

Lp(a) in daily clinical routine: risk-factor for both cardiovascular events and heart-failure? A retrospective analysis of the Luebeck Lp(a) heart-failure (HF) registry in patients after myocardial infarction

Matthias Mezger  1   2 , Tilmann Solle  1 , Dominik Jurczyk  1 , Caroline Fatum  1 , Felicitas Lemmer  1 , Ingo Eitel  1   2 , Christina Paitazoglou  1   2
Affiliations

Lp(a) in daily clinical routine: risk-factor for both cardiovascular events and heart-failure? A retrospective analysis of the Luebeck Lp(a) heart-failure (HF) registry in patients after myocardial infarction

Matthias Mezger et al. Atheroscler Plus. .

Abstract

Background and aims: Atherosclerotic cardiovascular disease (ASCVD) is a major health burden being the leading cause of death in Europe. Lipoprotein (a) (Lp(a)) is an important risk factor for CV events reflected by the 2019 ESC recommendation of a once in a lifetime Lp(a) measurement. Furthermore, heart-failure (HF) is the number one diagnosis for hospital admission in Germany and Europe. HF and ASCVD share common well-known risk factors, e.g. diabetes, obesity and hypertension. So far, there is scarcity of data regarding the relationship between Lp(a) and HF. We hypothesized that Lp(a) might be elevated in a high-risk ASCVD patient collective and that there might also be an association with heart-failure.

Methods: The Luebeck Lp(a) HF registry is a combined retrospective/prospective single-center, all-comers registry which investigates the relationship between Lp(a) and HF. The retrospective analysis reported here, comprises patients who were admitted to our heart-catheterization laboratory in the year 2021 due to ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI).

Results: We found that Lp(a) was assessed only in a minority of patients presenting with STEMI (33 %) and NSTEMI (14.6 %), p < 0.001. There was no relationship between Lp(a) level and ejection fraction (EF) or NTproBNP as surrogate markers for HF, respectively. Statin pretreatment was more frequent in patients with NSTEMI (31.1 %) compared to STEMI patients (11.3 %), p < 0.001.

Conclusion: Despite ESC recommendation, routine Lp(a) measurement is only rarely performed even in a high-risk patient collective. In patients with MI, we could retrospectively not observe a correlation between Lp(a) levels and heart failure, as assessed by surrogate markers as EF and NTproBNP.

Keywords: Heart-failure; Lp(a); Myocardial infarction; Pelacarsen.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
Lp(a) and LV-EF LV-EF was recorded and compared between patients (STEMI & NSTEMI) with Lp(a) < 150 nmol/l (n = 509 patients) and >150 nmol/l (n = 18 patients), showing no difference between both patient collectives: LV-EF for patients with Lp(a) > 150 nmol/l was 44 % (35, 55) and for patients with Lp(a) < 150 nmol/l 50 % (38, 55), respectively, p = 0.252.
Fig. 2
Fig. 2
Lp(a) and NT-proBNP NT-proBNP was analyzed for patients with Lp(a) > 150 nmol/l (n = 18 patients) vs. Lp(a) < 150 nmol/l (n = 509 patients). No difference regarding NT-proBNP levels could be detected: NT-proBNP for patients with Lp(a) > 150 nmol/l was 2018 pg/ml (379, 3545) compared to 2054 pg/ml (535, 7879) for patients with Lp(a) < 150 nmol/l, p = 0.331.
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